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l1lF IDl~VI?
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~ 3TATS OF FLORIDiA )
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ST. LUCI$ COUNTY )
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Personally appeared before me, the umdersigr~ed authority.
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suthorized to administer oaths and take-ackn~Wledgients, Pi1~RS1~T
SYLVIO RUBIN, JR., who, after being first duly swrn, deposes
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! T~hat he is the son of 1~?ndre~ Sylvio Rubin, Sr., aad $liza-
beth Rubin, and was burn F~ebruary 28, 19~3 j in Midland Park. ~iew _
~Jersey; that he now resides at 4107 South Indiaa River Drive.
;~Fort Pierce, Florida; that he is sometimes known as 1~E SYLVIO
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RUBIN, JR. , . , , ~ _t.......~ ....s~_
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that his bitth certificate was registered in the naoe of ~i4DR~T ~ ~
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i` SYLVIO RUBIN, JR. s that his baptisaoal c~ertificate was reqiste=ed
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f ~;in the name of ANDRE SYLVZO RiJBIB, ~R•; that his social security ~
' ~f registration ia in the name of l~bIDRS SYLVIO Rt~IH, JR. ; and that ~ .
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~ all are one and the sam~e person.
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~ Sworn to and subscribed before me . `
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this ~y of • }
A. D. 19~.
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. ~iblic. 3tate of Florida
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